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Last updated on April 15, 2020.

Do you work in public health or media, or in another business that would like to partner with Evidation on COVID-19 Pulse? Please reach out to us at press [at] evidation.com.

To understand how Americans are coping with the spread of COVID-19, Evidation Health, the health and measurement company, has launched a nationwide initiative tracking people’s attitudes toward and experiences during the pandemic, alongside their health. More than 185,000 (as of April 14) people from across all 50 states and the District of Columbia have agreed to participate, recruited in less than a month from the nearly 4 million people who use Evidation’s Achievement app—the largest, most diverse virtual research site in the U.S. This effort will track attitudes, behaviors, and health on a regular basis over the course of the coronavirus pandemic.

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April 15, 2020 update:

Our updates for April 15th are focused on the secondary effects of the coronavirus pandemic. We review how access to ongoing care and prescription drugs has been disrupted, concerns about maintaining health, fears around seeking care during this difficult time, and the adoption of telemedicine as a substitute. This data has been analyzed across 8 major conditions, selecting from 39 we track—if you’re interested in others, please contact us. This update also includes a wrap-up on activity decline through the month of March and extending through the first week of April. Survey results are not weighted.

Care is being significantly disrupted.
A third of individuals report that they had to miss or cancel previously scheduled appointments in the last 2 weeks (responses from 3/31–4/8). Seven percent report being unable to obtain their prescription drugs or that they have stopped taking drugs as prescribed. Across the board, these disruptions are affecting higher proportions of individuals with high need chronic conditions.

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Individuals have concerns about maintaining their health, and more broadly, are fearful.
Nationwide, 20% of individuals reported being worried or very worried about maintaining their health through ongoing care, including doctor’s appointments and obtaining their medications. More broadly, fear is significant—42% are worried or very worried about going to the doctor’s office or the ER for necessary care, and an additional 10% report being so worried that they would avoid seeking necessary care. When looking more closely at individuals suffering from major chronic conditions, these numbers are higher in every condition.

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While telehealth has become the go to option, there is still a significant gap to close.
For those individuals who had reported having their regular access to medical care disrupted (those who had cancelled appointments or were unable to get a face to face appointment in the prior 2 weeks), 39% report using some form of telemedicine (live video, phone, text, or email)—leaving more than 60% who have simply abandoned care they would have otherwise received. For those with chronic conditions, telemedicine can be a lifeline—and while utilization has been impressive in this short period, it’s clear that care gaps are looming on the horizon with more than half of the individuals with type 2 diabetes, hypertension, migraine and many more conditions not yet substituting care.

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Declines in physical activity have plateaued. For now.
Physical activity has declined by 48% through April 6th, indexed to March 1st. Across the board, states have seen dramatic negative changes in activity, with all 50 states plus the District of Columbia now showing more than 30% drops, and nine states showing activity declines of greater than 50%. Since the end of March, and through the first week of April, these steep changes have leveled off and held stable just below 50%.

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Hit the Keep reading button for previous updates from March.

 


 

March 27, 2020 update:

Our updates for March 27th include how physical activity has trended through March 24th (as more stay at home orders roll out across the country), a detailed look at two specific counties in the U.S., and our first look at sleep. We also share some brief highlights on the week-over-week changes in sentiment about the pandemic.

Physical activity in the U.S. continues to decline.
As we wrote in our prior update, we didn’t believe the bottom of the physical activity decline had yet been seen. With an additional four days worth of data, the bottom has in fact fallen even further, with physical activity now down 39% nationwide since March 1st.

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Social distancing and “stay at home” orders are correlated with local variation in activity.
We looked closely at the change in physical activity since March 13th in two counties: Orleans Parish (New Orleans) and Santa Clara County. Both counties experienced their steepest decline in physical activity upon the announcements of their stay at home orders—Santa Clara’s four day lead time is observable in the activity data and may have been the difference in keeping people isolated from one another. The degree of change in physical activity may have been an indicator of what was about to unfold in New Orleans, which has since become one of the U.S.’s coronavirus hotspots.

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Time asleep has increased nationwide.
Across the country, time asleep is up almost 20% since March 13th. As more Americans face the reality of working from home, or for our most unfortunate—an inability to work—that likely also means shorter (i.e., zero) commute times. Amongst the four states that have experienced more than a 25% increase in time asleep, two states (Maryland and New Jersey) rank in the top 3 for commute length.

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Week-over-week, attitudes and feelings are changing fast. 
Looking across the 88,509 individuals who completed an initial survey between 3/12 and 3/18, and then completed a subsequent survey between 3/19 and 3/25, it’s clear that sentiment is changing extremely quickly. We found (results are not weighted):

  • 51% are now worried or very worried someone in their household will get coronavirus versus 35% the week prior
  • 30% now believe coronavirus represents a catastrophic threat to public health, versus 14%
  • 30% now plan to first seek care via telemedicine (over PCP, ER, urgent care), versus 19%
  • 49% are now reporting experiencing anxiety in the prior week, versus 29%

 


 

March 22, 2020 update:

Key findings from the first analysis of wearable device data, looking at physical activity from February 23rd to March 20, 2020 are:

Physical activity in the U.S. is seeing its quickest decline, ever.
Physical activity (as measured by steps) is down more than 26% since President Trump declared a federal emergency on March 13th. Every single U.S. state, along with the District of Columbia has experienced a negative change in physical activity. Requests (or mandates) to #StayHome, closures of non-essential businesses in many states, along with the general push for social distancing has precipitated this decline. As more states adopt “shelter-in-place” requirements, it is likely that we haven’t yet seen the bottom.

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Many states, particularly those in the southeast, are lagging.
In the case of Florida, which as of March 22 has more than 1,000 known cases, it has taken longer to get people to start distancing and staying home. Physical activity did not decline by more than 5% until March 16, and they were behind more than 30 other states in reaching a 20% decline in activity.

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At the local level, there is a wide difference between counties.
Physical activity in New York is down 50% in just the last week, while other locales lag behind. Much has been made of cities like New Orleans and Miami not taking the requirements seriously enough—and it bears out in the data.

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March 18, 2020 update:

Key findings from the first survey, conducted from March 12 to March 15, 2020 are:

Few think the U.S. is prepared.
Only 23 percent think the United States is prepared or very prepared to deal with coronavirus, and nearly half (49 percent) of all respondents believe the coronavirus represents a catastrophic or major threat to public health.

Washing hands, not yet distancing.
Nearly twice as many people have reported washing their hands more frequently over the past seven days as have reported avoiding large gatherings (64 percent to 34 percent)

Anxiety up.
One-quarter (25 percent) of respondents reported increased anxiety in the past seven days.

Uninsured more worried about personal finances.
52 percent of those without health insurance are worried about not being able to work and earn a living because of the coronavirus disruptions as compared to only 36 percent of those with insurance.

Uninsured less likely to seek care, more likely to go to the ER.
Those without health insurance are two-and-half times less likely to seek care if they have symptoms of coronavirus. Those uninsured who would seek care are 7 percentage points more likely to go to the ER than insured (26 percent to 19 percent).

Overall, nearly 4 in 10 (37 percent) would seek care in the ER or an urgent care clinic if they believe they have symptoms of coronavirus.

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Increasing concern about food shortages.
Last week, respondents became increasingly worried about not having enough food with 23 percent on March 12 reporting they bought extra food and 43 percent reporting that three days later.

More worry about the economy than lack of hospital beds.
More worry about the economy than lack of hospital beds. Despite warnings from public health experts that there will not be enough hospital beds in the US, only 17 percent worry that hospital beds will run out as compared to 42 percent who said they worried about a financial market crash.

States vary widely in their responsiveness to the crisis.
D.C. with the 3rd highest known case counts per 100,000 residents (as of March 18) has reacted strongly to the crisis, whereas states like Louisiana perceive the country is prepared (3rd highest percentage of residents believing the U.S. is prepared or very prepared, of all states and D.C.) and did not react as strongly by this past weekend (3/15).

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Methodology
For this initiative, Evidation launched a new program in Achievement for individuals to share what they thought about the coronavirus pandemic, including their perceptions, knowledge, and changes in behavior, in addition to their individually-permissioned activity data. In this initial release of 100,258 adults, 89 percent—or 2,973—of all U.S. counties are represented. Results are not weighted.

Further reading